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Full text of "Medical Jurisprudence And Toxicology"

442                                             MEDICAL JURISPRUDENCE

gastric mucous membrane was perceptible nineteen months after interment,7
and in the other case the hypersemic condition of the stomach and intestines
was evident when the body was exhumed after twenty-one months' burial.8

2.    Softening. — Softening of the mucous membrane of the stomach, espe-
cially at its cardiac end and greater curvature, is usually caused by the
action of corrosive poisons, chiefly alkaline corrosives.    It is also observed
in the mouth, throat and oesophagus.   But when caused by disease it is con-
fined to the stomach alone and is1 commonly found at its cardiac end.

Some corrosive poisons, such as carbolic acid, produce hardening and
shrinking of the mucous membrane instead of softening.

Softening caused by putrefaction commences at the most dependent
parts and affects all the coats of the stomach without the detachment of its
mucosa and the softened patch is not surrounded by an inflamed area as is
the case in corrosive poisoning.

3.   Ulceration. — Ulceration caused by corrosive or irritant poisons is
generally found at the greater curvature of the stomach, and presents the
appearance of an erosion with thin, friable margins and surrounded by the
softened mucosa due to intense inflammation.   An idiopathic gastric ulcer
is situated frequently on the lesser curvature with sharply  defined, but
thickened and indurated edges.   The mucous membrane is commonly red-
dened only in the neighbourhood of the ulcer ; while the redness is generally
diffused over other parts of the stomach and extends upto the duodenum
and small intestine when the ulcer is due to a corrosive or irritant poison.

4.    Perforation. — Perforation of the wall of the stomach or small intestine
resulting from corrosive poisoning is rare, though it may be met with in
cases of suliiturie^acid poisoning.   Perforation caused by poisoning must be
distinguished from one caused by disease or by the post-mortem action of
the gastric juice.

In a perforation caused by poisoning the aperture is feg&e, the edges are
ragged and irregular and the coats are easily lacerated. Ifee tissues round
the margins are distintegrated beyond the edges of the aperture. The
stomach in such a case is charred owing to the severe corrosive action.

•- -If a perforation has been the result of a chronic ulcer due to disease, the
aperture is commonly oval or rounded, the margins are more or fe^s
punched out, and the stomach does not show the signs of charring but it
shows chronic adhesions to the neighbouring organs. Very rarely, perfora-
tion may follow an ulcer caused by irritant poisoning, when its aj^e^rance
will be similar to that produced by the idiopathic ulcer.

In a perforation produced after death by auto-digestion of ifee stomach
by the gastric juice the aperture is vesry laprge and irregular w$fa ECH^h aaad
pulpy edges ; there is no inflammation or Aairring of the stonia^S, wfc Ae
surrounding mucous membrane is often softened and gelatinous.

B.   CHEKBCAL ANALYSIS

The most important proof of poisomng is the detection of poison in tjbe
excreta (vomit, urine, etc.) during life, sind in the contents of the stomach
and bowels,, and in the tissues of the body after death. The finding of poism
in food, medicto W miy oiher sus|>ected substance is corroborative, but not
conclusive proof ; for the poison may have been added to any of these sub-
stances fust to sabsfeoitiaie a false charge against an enemy. : In cas^s of
feigned poisoning it is advisable to elicit from the patient tte |>ois©a fee
suspects to have i^ea .acipaiiiistered to him, so as to note if

On
Ibid., Reg. v. Bacot^ LM^E^^^ELer Assizes, 1857,